TRICARE Policy Manual 6010.63-M, April 2021Chap 11ProvidersRevision: C-23, Oct 23, 2024Section/Addendum Subject/Addendum Title1.1Providers - General1.2Institutional Provider, Individual Provider, And Other Non-Institutional Provider Participation2.1Department of Veterans Affairs/Veterans Health Administration (DVA/VHA) Health Care Facilities2.2Employer-Operated Medical Facilities2.3Birthing Centers2.4Eating Disorder Programs2.5Psychiatric And Substance Use Disorder (SUD) Partial Hospitalization Program (PHP) Standards2.6Psychiatric Hospitals Accreditation2.7Intensive Outpatient Program (IOP) Standards2.8Opioid Treatment Program (OTP) Standards2.9Residential Treatment Center (RTC) Standards2.10Freestanding End Stage Renal Disease (ESRD) Facilities3.1Physician Referral And Supervision3.2State Licensure And Certification3.3Accreditation3.4Nurse Anesthetist3.5Anesthesiologist Assistant (AA)3.6Certified Clinical Social Worker (CSW)3.7Certified Psychiatric Nurse Specialist (CPNS)3.8Clinical Psychologist3.9Certified Marriage And Family Therapist3.10Pastoral Counselor3.11Mental Health Counselor3.12Certified Nurse Midwife (CNM)3.13Certified Physician Assistant (PA)3.14Registered Dietitian (RD)3.15Nutritionist3.16Physical Therapist Assistants (PTAs)3.17Occupational Therapy Assistants (OTAs)4.1Unauthorized Institution: Related Professional Services4.2Unauthorized Provider: Emergency Services5.1Provider Standards For Potentially Human Immunodeficiency Virus (HIV) Infectious Blood And Blood Products6.1Ambulatory Surgery6.2Freestanding Ambulatory Surgery Center (ASC)7.1Certification Of Organ Transplant Centers8.1Inpatient/Residential Substance Use Disorder Rehabilitation Facilities (SUDRFs) Standards9.1Other Provider Certification9.2State Vaccine Programs (SVPs) As TRICARE-Authorized Providers10.1Services Rendered By Employees Of Authorized Independent Professional Providers11.1Birthing Center Accreditation11.2Birthing Center Certification Process11.3Certified Marriage And Family Therapist Certification Process12.1Corporate Services Provider (CSP) Class12.2Qualified Accreditation Organization12.3Participation Agreement RequirementsAParticipation Agreement For Certified Marriage And Family TherapistBParticipation Agreement For Freestanding Or Institution-Affiliated Birthing Center (BC) Maternity Care ServicesCApplication Form For Corporate Services ProvidersDParticipation Agreement For Inpatient/Residential Substance Use Disorder Rehabilitation Facility (SUDRF) Services For TRICARE BeneficiariesEParticipation Agreement For Residential Treatment Center (RTC)FParticipation Agreement For Freestanding And Substance Use Disorder (SUD) Psychiatric Partial Hospitalization Program (PHP) ServicesGParticipation Agreement For Intensive Outpatient Program (IOP) ServicesHParticipation Agreement For Opioid Treatment Program (OTP) ServicesIParticipation Agreement For Intensive Outpatient Program (IOP) Services as Part of the IOP Pilot for Psychological Health Sequelae of Sexual Trauma